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A spokesman for the FDA confirmed in an e-mail that the agency is stepping up its efforts abroad, including in India. “The problems FDA investigators encounter in India are similar to those seen around the world in manufacturing,” according to an FDA representative. With more and more companies such as Apotex making drugs in other countries, FDA inspectors were spread far too thin. Last year, the Indian government approved adding seven new FDA drug investigators, to bring the total up to 19 U. “What we’ve found is that most Indian firms understand good manufacturing practices and use them, but we’ve seen problems with a few companies," the representative said. For example, in the last year, the FDA has sent warning letters about manufacturing or packaging violations not only to companies with plants in India, but also to companies operating plants in Australia, Austria, Canada, China, Germany, Japan, Ireland, and Spain. In 2012, Congress passed the FDA Safety and Innovation Act, which among other things, requires the agency to inspect foreign facilities that make drugs sold in the U. "That’s why we‘ve chosen to make quality one of our highest priorities this year.” The agency also says that import bans affect only a fraction of the drugs made in India for the U. Common issues include inadequate testing and quality checks, inconsistencies in data collection, and contaminated products. In particular, imports of drugs and medical devices from China increased by nearly fivefold from 2007 to 2013, and the FDA is scrambling to keep up. Our review of FDA import alerts reveals that the agency sanctioned about as many Chinese factories in the last five years as it did those in India. (Under these alerts, products can be stopped from coming into the U. until the importer proves that they comply with relevant laws and regulations.) 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